HomeMy WebLinkAboutBuilding Permit 99-0178
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS 56LtIJ
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMIN~G
iESULAT
FINAL
SITE INSPECTION
COMMENTS:
SCHEDULE~ ~~
NlnntJ~ Sr
TIME
~r
CONTR.
PERMIT NO.
qf(- /75
o PLUMBING RI 0 EX/GRAD/FILLING
o MECH RI 0 COMPLAINT
o WATER HOOKUP 0 FIREPLACE RI
o SEWER HOOKUP 0 FIREPLACE FINAL
o PLUMBING FINAL 0 GASLINE AIR TST
o MECH FINAL 0
Srd..;h<:,. ~I'Y\ pl~hd
;:::--- I __________
( /l' ,-1 ~
~~ -J/
------- .
CALL 447-9850~OR THE l :XT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIRE~RE FOR YOUR PERSONAL HEALTH & SAFETYl
INSNOTl
DATE RECEIVED
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
.'ee
, DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
1. DATE
::: / Its. /1/
.5'7 f{2-
PlDd5-004 - ();;} If-o
wsk/lo-s Add./-1 .
2. SITE ADDRESS
5"" 0 y~O
J1/lvn -r!!"S~ t:) ~
3. LEGAL DESCRIPTION
LOT , BLOCK ~
ADDITI~ /A) 5D I {~ /t, .f- c- 9J' {1"F /7-2.
4. OWNER (Name)
~ eo.-"I
5. ARCHITECT (Name)
6. BUILDER (Name)
>ee--^ E
(Address) , /
H&\#~f04/ ('
(Address)
(Tel. No.)
W7~6B'~
(Tel. No.)
...-
Z-
(Address)
(Tel. No.)
H~4L*"&-(./J-'
Septic 0 Deck 0
Addition 0 Finish Attic 0
o/'Y"7-6~ry
Re-roofing 0 Porch 0
Re-sidin~sh Basement 0
7. TYPE OF WORK
New Construction 0
Fireplace 0
Alterations 0
Chimney 0 Misc.
8. PROPERTY AREA OR ACRES
Sq. Ft.
9. PROPERTY DIMENSIONS
Width Depth
1 O. CULVERT SIZE
Yes No
L White
2. Pink
3. Yellow
File
City
Applicant
Permit No. '11 -\15
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
12. NO. OF STORIES
13. TYPE OF CONSTRUCTION
14. FLOOR AREA APPORTIONMENT USE
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
SEATS
16. PROJECT COSTNALUE
7';~
17. COMPLETION DATE
6 - / 49
I hereby certify th have fumished information on this application which is to the best of my knowledge true and correct. I also certify that I am the owner or authorized agent for
d pro~e. and that all construction w.i11 conform to all existing state and local laws and will proceed in accordance with SUb. mitted plans. I am aware that the
n revok i p~o~hermore. I hereby agree that the city official or a designee may enter upon the property to perform needed inspections.
G.-//~~ 3~L#J-99
Signature License No. Date
x
C/"
FOR ADMINISTRATIVE USE
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ....................... ~
Sewer Tap ................................... $
$
Pressure Reducer .......................... $
Meter Horn ................................... $
Water Meter ................................. It
Sewer & Water Connection Fee ........... $
Water Tower Fee ........................... $
WaterTap ................................... $
Builder's Deposit ............................ $
Other ......................................... $
Paid (/iJe ...................~~~~i~;~:.
SETBACKS: Required
Actual
Front
8ack
Side
Side
BUILDING DEPARTMENT VALUATION
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
USE OF BUILDING ,
~.
fe:..
'2.eC>O.C9 0
/
;:; / j(
I
PERMIT VALUATION
TYPE OF CONSTRUCTION: I II III IV
Occupancy Group A B E F HIM
Division 1 2 ~ 4
..Pern1ifl?6e'::-::~........ ..................... $
f-
(' ~............................. $
< State Surch~e ..y........................ $
Penalty ....................................... $
Plumbing Permit Fee ....................... $
C0
#?S U
City:
74. Ie:::
l ''6S-
Mechanical Permit Fee ..................... $
Sewer & Water Permit ...................... $
it ~.:."l..:~;;;.;,:._~
_ ~ilO Date <_ /'G-7 /
Y -
Certificate of Occupancy
Issued
Date
MATERIAL FILED WITH APPLICATION
SOIL TESTS 0 ENERGY DATA 0
PILING LOGS 0 PERCOLATION TESTS 0
PLANS & SPECS 0
SURVEY 0
PLOT PLAN 0
SETS
COPIES
/(,.CX5'
(k.{:J#
34 7AI
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning Ordinance and may proceed as requested. This document when
signed by the City Planner const~utes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy. a Certificate of Occupancy must be issued.
By
City Planner
Date
Special Conditions n any
24 hour notice for all inspections 447-9850